The War on AMR is Not Working: a New Ecological Perspective on AMR Offers Insights for Global Governance

The War on AMR is not working. A new Global Strategy Lab (GSL) study published in Perspectives on Politics, led by GSL Investigator Dr. Isaac Weldon Link and GSL Director Dr. Steven Hoffman Link , introduces five new principles for creating institutions that can reduce drug resistance and increase our chances of achieving sustainable antimicrobial use for all.

This study looks at antimicrobial resistance (AMR) as an outcome of the relationship between human societies and invisible microbial worlds. Over the past century, the discovery of antimicrobials has changed how we live with germs, shifting our relationship with them. The article asks, “Is our current system of global governance capable of sustainably managing the relationship between these two worlds?” It answers this question by looking at how well human societies fit with the basic features of microbial ecosystems, similar to checking if a key fits a lock. 

With this subtle shift in perspective, the article identifies problems in our current approach to global AMR governance and introduces principles for creating new institutions that can reduce drug resistance and increase our chances of achieving sustainable antimicrobial use for all. 

Antimicrobial resistance cannot be stopped, but it does speed up when we misuse and overuse antimicrobials. It can be slowed down through better use and management of the antimicrobials we already have. The impact of AMR can also be mitigated with the development of new treatments. AMR does not only affect human health. It also affects animals, agriculture, the environment, development, and trade. 

The authors introduce five new principles for building institutions to better harmonize the relationship between human microbial ecosystems, while maintaining our ability to treat infectious disease.

  1. There’s no silver bullet. Recognizing that there is no easy fit or one-fits all solution for AMR means problem-solving must always be tailored to specific ecological situations and health challenges of diverse populations.
  2. Create institutions that can adapt over time. Future proofing doesn’t mean creating institutions that are strong enough to withstand change, but ones flexible enough to evolve with the changing nature of AMR and our relationship to it.

3. Diversify practices. As the best way to tackle AMR is still unknown, diversifying practices can help us discover what works, when, and where.

4. Create records. As practices are diversified, records need to be kept of what works to enable learning and adjustments in policy.

5. Involve stakeholders. This involves everyone from the public at large, to government and decision makers.

As we continue to develop ways to create appropriate global action for AMR, finding political and policy strategies that can adapt to the evolving problem of human interactions with microbes will help to achieve sustainable antimicrobial use for all. 


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